Outcomes assessed at one year adjusted age All children were evaluated at one year adjusted age at a Development Evaluation Clinic dedicated solely to developmental assessments of high-risk infants. The primary outcome, the Bayley Scales of Infant Development-Second Edition (BSID-2) Mental Developmental Index (MDI)I, and two secondary outcomes - the BSID Pyschomotor Developmental Index (PDI) and the Vineland Adaptive Behavioral Scales (VABS) were assessed by child psychologists or psychology graduate students supervised by a child psychologist, who were not aware of the child's intervention group or medical history. After the testing was completed, the psychologist was informed of the infant's gestational age at birth, so that the BSID scores could be corrected for the degree of prematurity. The BSID MDI is a widely used and validated developmental assessment tool to measure cognitive development in the first two years of life. The BSID PDI measures fine and gross motor development.29 The population mean for both the scores is 100 with a standard deviation of 15. Higher score on BSID MDI and PDI represents better cognitive and motor functioning respectively.30 When the BSID MDI/ PDI score was less than 50, then the score was extrapolated as described previously.31